Anxiety, depression and quality of life in acute high risk cardiac disease patients eligible for wearable cardioverter defibrillator: Results from the prospective multicenter CRED-registry

• Published in: PloS one Vol. 14; no. 3; p. e0213261
• Main Authors: Weiss, Michael, Michels, Guido, Eberhardt, Frank, Fehske, Wolfgang, Winter, Stefan, Baer, Frank, Choi, Yeong-Hoon, Albus, Christian, Steven, Daniel, Baldus, Stephan, Pfister, Roman
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 11.03.2019; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Analysis; Anxiety; Anxiety Disorders - complications; Anxiety Disorders - diagnosis; Beta blockers; Biology and Life Sciences; Cardiac arrhythmia; Cardiac patients; Cardiomyopathy; Cardiovascular disease; Cardiovascular diseases; Cologne; Coronary artery disease; Coronary vessels; Defibrillators; Defibrillators, Implantable; Depression (Mood disorder); Depressive Disorder - complications; Depressive Disorder - diagnosis; Engineering and Technology; Family medical history; Female; Health aspects; Health risks; Heart attacks; Heart diseases; Heart Diseases - complications; Heart Diseases - diagnosis; Heart Diseases - psychology; Heart failure; Hospitals; Humans; Implantable cardioverter-defibrillators; Internal medicine; Male; Medical prognosis; Medicine; Medicine and Health Sciences; Mental depression; Middle Aged; Mortality; Patients; Prospective Studies; Psychological aspects; Quality of Life; Registries; Risk; Signs and symptoms; Social Sciences; Wearable Electronic Devices; Germany
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0213261

Psychological distress is common in patients with cardiovascular disease and negatively impacts outcome. Psychological distress is high in acute high risk cardiac patients eligible for a WCD, and associated with low quality of life. Distress is aggravated by WCD. Consecutive patients eligible for a WCD were included in the prospective, multicenter "Cologne Registry of External Defibrillator" registry. Quality of life (Short Form-12), depressive symptoms (Beck-Depression Inventory II) and anxiety (State Trait Anxiety Inventory) were assessed at enrollment and 6-weeks, and associations with WCD prescription were analyzed. 123 patients (mean [SD] age 59 [± 14] years, 75% male) were included, 85 (69%) of whom received a WCD. At enrollment 21% showed clinically significant depressive symptoms and 52% anxiety symptoms, respectively. At 6 weeks, depressive and anxious symptoms significantly decreased to 7% and 25%, respectively. Depressive symptoms at enrollment and changes at 6 weeks showed significant associations with health-related quality of life, whereas anxious symptoms did not. There was a trend for better improvement of depression scores in patients with WCD (mean [SD] change in score points: -4.1 [6.1] vs -1.8 [3.9]; p = 0.09), whereas change of the anxiousness score was not different (-4.6 [9.5]) vs -3.7 [9.1], p = 0.68). In patients eligible for a WCD, depressive and anxiety symptoms were initially common and depressive symptoms showed a strong association with reduced health-related quality of life contributing to their clinical relevance. WCD recipients showed at least similar improvement of depression and anxiety at 6 weeks when compared to non recipients.